Organization
DAFRANER ENTERPRISES PLC
Active
Other names
David A Becker Sole MBR
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BECKER APRN, PMHNP (OWNER)
(616) 818-5494
Entity
Organization
Contact information
Practice address
1000 PARCHMENT DR SE, GRAND RAPIDS, MI 49546-3663
(616) 957-9112
(616) 957-2409
Mailing address
134 PROSPECT AVE NE, GRAND RAPIDS, MI 49503-3321
(616) 818-5494
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704269668
STATE NURSE PRACTITIONER LICENSE
MI
Enumeration date
12/20/2017
Last updated
12/20/2017
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